WALNUT CREEK MEDICAL GROUP NPI 1871582155

NPI Information

  • NPI: 1871582155
  • Provider Name: WALNUT CREEK MEDICAL GROUP
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 05D1094052
  • Address: 2621 SHADELANDS DRIVE
    WALNUT CREEK, CA
    ZIP 94598
  • Phone: (925) 947-0417

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NPI Details

WALNUT CREEK MEDICAL GROUP is a family medicine in Walnut Creek, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WALNUT CREEK MEDICAL GROUP NPI is 1871582155. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2621 SHADELANDS DRIVE
WALNUT CREEK, CA
ZIP 94598
Phone: (925) 947-0417
Fax: (925) 947-4379

The provider's authorized official is Maeve O'regan .
The authorized official title is Partner and has the following contact phone number (925) 947-0417.

The CLIA number assigned to this NPI record is 05D1094052 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2005 and was last updated on 12/30/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineA42969CALIFORNIANo
2207Q00000XFamily MedicineG370050CALIFORNIANo
3207R00000XInternal MedicineA55743CALIFORNIANo
4207R00000XInternal MedicineA50662CALIFORNIANo
5207Q00000XFamily MedicineG42383CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1A48935MEDICARE UPIN
200G370050MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
300G423830MEDICARE ID-TYPE UNSPECIFIED
400A557430MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
5A55743MEDICARE UPIN
600A506620MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
700A429690MEDICARE ID-TYPE UNSPECIFIED
8H49380MEDICARE UPINCALIFORNIA
9A50662MEDICARE UPIN
10A42969MEDICARE UPIN
11G37005MEDICARE UPIN
12H66606MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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